Panaji: While physical pain is often the most visible aspect of cancer, patients in Goa are grappling with a complex web of emotional and mental issues that require comprehensive support throughout their journey. Healthcare providers and family members must navigate a delicate balancing act, first helping patients accept their diagnosis and then carefully managing the psychological turmoil that accompanies treatment.
The Psychological Toll of Cancer Diagnosis
According to health experts, every cancer patient needs substantial assistance to handle multiple challenges once they become aware of their condition. The initial reaction typically involves a mix of anger, shock, and spiritual questioning, particularly among those who led healthy lifestyles.
"This is seen especially when they lived well and did not do any substance abuse. They struggle to find an explanation for why this is happening to them," said Sameer Cuncolkar, a counsellor at the Goa Medical College's oncology department.
Case Studies Reveal Deep Struggles
A young photographer in his twenties undergoing leukemia treatment at GMC responded so poorly to his diagnosis that he required regular therapy sessions. "As he had a retinal bleed affecting his vision, he was petrified this would affect his profession," explained Dr. Anupama Borkar, head of GMC's oncology department. "He was depressed, and counsellors sat with him every day to try to lift his spirits."
After being referred to the ophthalmology department and undergoing eye surgery, his vision improved significantly, though not completely restored. This case illustrates how cancer's secondary effects can create additional psychological burdens beyond the primary diagnosis.
Specialized Mental Health Interventions
While most cases are managed by counsellors within GMC itself, a small percentage require referral to specialized institutions like the Institute of Psychiatry and Human Behaviour. One such case involved a 52-year-old man working in the UK, diagnosed with laryngeal cancer two months earlier.
"He was referred from GMC with a history of difficulty coping with the diagnosis and insomnia for 15 days," said Mary D'Souza, head of the IPHB department. "He experienced crying spells and feelings of helplessness, which was diagnosed as adjustment disorder."
The treatment involved both medication and comprehensive counselling that included psychoeducation and psychotherapy for both the patient and his family members.
Range of Mental Health Challenges
Mental health problems among cancer patients encompass various conditions including adjustment issues, anxiety, depression, and sometimes acute organic brain syndromes like delirium. "Caregivers also face adjustment issues, burnout, and depression," D'Souza added, highlighting that the psychological impact extends beyond patients to their support systems.
Tele-MANAS: A Digital Lifeline
The government's Tele-MANAS distress helpline has emerged as a crucial resource for cancer patients experiencing emotional distress. A 65-year-old breast cancer patient reached out in a state of profound distress, paralyzed by denial and anger while struggling with the "why me" aspect of her illness.
"She viewed the diagnosis as an inevitable end and losing all hope in treatment," noted Dr. Sneha Pokle, senior consultant psychiatrist at Tele-MANAS. The team intervened with targeted psychoeducation and consistent follow-ups to monitor her wellbeing as she began medical treatment.
Ongoing Support Through Treatment Phases
The treatment phase introduced new challenges as the patient began experiencing severe mood shifts, ranging from excessive talking to alarming thoughts of suicide. Recognizing the high risk, the Tele-MANAS team immediately engaged with her caregiver to provide emotional support and strategies to reduce caregiver burden.
A timely referral to the psychiatry OPD resulted in medication to manage acute clinical stress. "While she still faces occasional isolation and the fear of recurrence common to many survivors, the Tele-MANAS team remains her permanent emotional anchor through ongoing, active follow-up care," Pokle emphasized.
This comprehensive approach demonstrates how addressing mental health needs is becoming increasingly integrated into cancer care protocols in Goa, recognizing that healing requires attention to both physical symptoms and psychological wellbeing.
